Many Misuse Aspirin for Prevention of Cardiovascular Events

A recent analysis has found that nearly 50% of patients using aspirin for primary or secondary prevention of cardiovascular disease were failing to follow proper use guidelines.

Results of the analysis revealed 36% of patients were underusing aspirin per the 2009 USPSTF recommendations and an additional 9% of users were self-medicating without an indication for use.

In an effort to assess rates of over and underuse of regular low-dose aspirin in those with an increased risk of cardiovascular disease, investigators conducted an analysis using data from patients in five Upper Midwestern states in 2015. Through a telephone survey, investigators collected data including demographic, health history and aspirin use information from more than 3500 adult patients.

For inclusion in the study, male patients needed to be between the ages of 45 and 79 and female patients needed to be between 55 and 79 years of age. Additionally, patients included could not have a history of gastrointestinal bleeding, aspirin allergy, or anticoagulant use. Investigators defined primary prevention with low dose aspirin as those with age- and sex-specific elevated risk based on USPSTF recommendations.

A total of 3561 adults were included in the entire study population, of which 1742 were women and 1819 were men. Of the 3561 included in the study, 2947 were classified as primary prevention and 614 as secondary prevention.

Of the 2947 identified as primary prevention, 1874 had an indication for regular low dose aspirin. Investigators’ analyses revealed 33% of women and 36% of men were using regular low dose aspirin. Among patients with an indication for regular low dose aspirin, 54% of women and 61% of men were underusing. Among 1073 patients without an indication for regular low dose aspirin, 23% of women and 23% of men were regularly using low dose aspirin.

“There are significant portions of the population incorrectly using or not using ASA for primary prevention,” investigators wrote. “There is a need for increased public and healthcare provider awareness of the appropriate use of ASA(regular low dose aspirin) to maximize CVD prevention.”

This study, titled “Contemporary Aspirin Use for Cardiovascular Disease Prevention,” was presented at the American Heart Association (AHA) 2019 Scientific Sessions in Philadelphia.